Active NPI
Jorge Alberto Flores, D.D.S.
- Dentist
- Palmdale, CA
National Provider Identifier
1336461789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D42546
- Practice address
- 509 E. Palmdale B1.
Ste E
Palmdale, CA 93550 - Phone
- (661) 273-7800
- Fax
- (661) 273-7308
- NPI assigned
- Feb 25, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D42546 | CA | Primary |
Addresses
Primary practice location
509 E. Palmdale B1.
Ste E
Palmdale, CA 93550
Mailing address
509 E. Palmdale B1.
Ste E
Palmdale, CA 93550
Phone (661) 273-7800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G91936-02 | Other | CA | MEDICAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D42546 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267056000000",
"number": "1336461789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 E. PALMDALE B1.",
"address_2": "STE E",
"city": "PALMDALE",
"state": "CA",
"postal_code": "93550",
"telephone_number": "661-273-7800",
"fax_number": "661-273-7308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 E. PALMDALE B1.",
"address_2": "STE E",
"city": "PALMDALE",
"state": "CA",
"postal_code": "93550",
"telephone_number": "661-273-7800",
"fax_number": "661-273-7308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLORES",
"first_name": "JORGE",
"middle_name": "ALBERTO",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-25",
"last_updated": "2010-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "D42546",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "G91936-02",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palmdale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.